Business Segment Information (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Segment net revenues by major payer source
Total net revenues	$ 487,505	$ 415,591
Medicare [Member]
Segment net revenues by major payer source
Total net revenues	372,000	360,400
Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	71,100	18,200
Commercial Insurance and Other [Member]
Segment net revenues by major payer source
Total net revenues	44,400	37,000
Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	15,600	14,300
Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues	28,800	22,700
Home Health [Member]
Segment net revenues by major payer source
Total net revenues	256,000	236,100
Home Health [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues	208,800	193,100
Home Health [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	8,500	11,200
Home Health [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	15,600	14,300
Home Health [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues	23,100	17,500
Hospice [Member]
Segment net revenues by major payer source
Total net revenues	174,400	179,500
Hospice [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues	163,200	167,300
Hospice [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	6,200	7,000
Hospice [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	0	0
Hospice [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues	5,000	5,200
Community Care [Member]
Segment net revenues by major payer source
Total net revenues	57,100
Community Care [Member] | Medicare [Member]
Segment net revenues by major payer source
Total net revenues	0
Community Care [Member] | Medicaid and Local Government [Member]
Segment net revenues by major payer source
Total net revenues	56,400
Community Care [Member] | Commercial Insurance and Other [Member] | Paid at Episodic Rates [Member]
Segment net revenues by major payer source
Total net revenues	0
Community Care [Member] | Commercial Insurance and Other [Member] | Other [Member]
Segment net revenues by major payer source
Total net revenues	$ 700